A Pilot Trial Using Telehealth in Radiation Oncology: The Future of Healthcare is Virtual

Abstract

Evidence demonstrates that social determinants of health, including zip code, socioeconomic status, and ease of transportation, can directly affect cancer survival. Driven by advances in technology, telemedicine has the ability to improve patient access to care, can potentially lower healthcare costs, and increase space in clinics for more efficient workflow. We performed a clinical trial using telehealth in the first post-treatment visit for radiation oncology patients to examine implementation, patient and physician satisfaction, and potential clinical implications. We conducted an IRB-approved pilot trial using a telehealth platform for the first post-treatment visit in patients completing radiation therapy for any cancer diagnosis between May 2016 and August 2018. To assess satisfaction, patients completed an 18-item patient satisfaction with cancer care (PSCC) questionnaire, a 14-item communication assessment tool (CAT), and a 10-item healthcare system distrust scale within 4 weeks of completing the telehealth visit. Physicians were asked to complete a 19-question survey regarding the ease of use and efficacy of the telehealth platform. The primary endpoint of this study was feasibility of using the telehealth platform, as defined by the ability to schedule and complete 5 post-treatment visits via telehealth per month. Secondary endpoints included patient and physician satisfaction with the telehealth encounter, as well as the ability to assess patients appropriately. A total of 37 patients were enrolled in the trial, with 24 evaluable patients defined as those who completed their scheduled telehealth visit. An average of 1.4 patients were accrued per month over the time period the study was open. All patients reported satisfaction with their care and that they had enough time with their physician. 85.7% of patients believe the communication they had with their physician via telehealth was excellent. Physicians were 100% satisfied that they were able to accurately assess the patient’s symptoms via the platform, while 82.3% of the respondents felt they could accurately assess treatment-related toxicity. Physicians assessing skin toxicity from breast radiation were the only respondents who did not feel they were able to do so using the platform. Telehealth used for post-treatment visits frees 1 out of 13 exam rooms so that additional new patient visits can occur. Telehealth is a platform that has potential for the field of radiation oncology and should be strongly considered for patients when appropriate. While some patients prefer to see their radiation oncologist in person, and although there are certain limitations in regards to conducting a physical exam to gauge treatment-related toxicity, our study has demonstrated that both providers and patients have identified telehealth as a suitable platform for radiation oncology visits.